Provider Demographics
NPI:1679104996
Name:AKERS, JESSICA CATHERINE (LMT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CATHERINE
Last Name:AKERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10422 208TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7220
Mailing Address - Country:US
Mailing Address - Phone:425-280-7105
Mailing Address - Fax:
Practice Address - Street 1:15418 MAIN ST UNIT M106
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-9021
Practice Address - Country:US
Practice Address - Phone:425-742-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61014649225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist